• Seung Baek Hong, Nam Kyung Lee, Suk Kim, Il Wan Son, Hong Koo Ha, Ja Yoon Ku, Kyung Hwan Kim, and Won Young Park.
• Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, and Pusan National University School of Medicine, Busan, Korea.
• J Magn Reson Imaging. 2020 Oct 1; 52 (4): 1249-1256.

BackgroundThe Vesical Imaging-Reporting and Data System (VI-RADS) is a newly developed system of bladder cancer staging with multiparametric MRI (mpMRI), which can be used to predict the presence of muscle invasion for bladder cancer.PurposeTo evaluate the accuracy of three mpMRI series (T2 WI, diffusion-weighted imaging [DWI], and dynamic contrast-enhanced image [DCEI]) and VI-RADS for diagnosing the muscle invasive bladder cancer (MIBC).Study TypeRetrospective.PopulationIn all, 66 pathologically proven bladder cancers in 32 patients.Field Strength/SequenceBefore the diagnostic MRI with an intramuscular antispasmodic agent, optimal bladder distension was confirmed. 3.0T MRI with T2 WI, DWI, and DCEI.AssessmentThree reviewers independently assessed and scored the bladder cancers in T2 WI, DWI, and DCEI using a five-point score system. Based on the scores in the three sequences, reviewers scored each bladder cancer with reference to VI-RADS categories. We evaluated the diagnostic performance of each of three mpMRI sequences and the final VI-RADS categorization for diagnosing MIBC.Statistical TestsSensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the area under the curve (AUC) of each of three sequences separately and VI-RADS categorization for diagnosing the MIBC.ResultsThe diagnostic performances of each of the three mpMRI series and VI-RADS for diagnosing MIBC were excellent. Especially using the optimal cutoff score >3 for predicting MIBC on DWI, DCEI, and VI-RADS, the sensitivity, specificity, PPV, NPV, and AUC values were 90% (95% confidence interval [CI]: 0.56, 1.00), 100% (95% CI: 0.94, 1.00), 100% (95% CI: 0.66. 1.00), 98.3% (95% CI: 0.91, 1.00), and 0.95, respectively. DATA CONCLUSION: mpMRI based on VI-RADS can stratify patients with bladder cancer according to the presence of muscle invasion.Level Of Evidence3.Technical Efficacy Stage2. J. Magn. Reson. Imaging 2020;52:1249-1256.© 2020 International Society for Magnetic Resonance in Medicine.

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